Why is the Wait For Mental Health Testing So Long?
One of the biggest concerns clients have when they call about setting up an appointment for mental health testing is the wait. Understandably, everyone would like to get in as soon as possible. Unfortunately, if a provider or health care organization does offer ADHD or ASD testing, the wait is often weeks to months to come in for an intake. After talking to many frustrated clients and would-be clients, I’ve decided to write this entry for my blog in hopes it helps potential clients understand what is going on and what they can do about it.
Fundamentally, the long wait times to get in for mental health testing comes down to a lack of providers and how health care insurance works.
Lack of providers/testing slots
Only a limited number of people can offer mental health assessments in MN; medical doctors, nurse practitioners, psychologists, or people trained by professionals to conduct mental health assessments. Minnesota has a significant shortage of those professionals. Next, testing takes a lot of time. An intake appointment is one hour. The testing appointment is two to three hours, depending on the age and ability level of the client. The feedback appointment takes an hour. Scoring test results, reviewing records, and writing reports takes one to three hours. Thus, a single test takes as much time as five to eight one-hour talk therapy sessions for a psychologist, and far more appointment slots than that for a medical doctor or nurse practitioner.
Some providers test every day, but even then, they only go through five assessments a week. A Licensed Psychologist could see 25-35 talk therapy clients over the course of a week.
A combination of a limited number of providers and the time it takes to complete testing means longer wait times for testing.
Money
Health care professionals, including psychologists, can be paid in three ways. First, they can work for a big company or a large practice that can afford to employ professional insurance billers who do all the work with the insurance companies and the provider is paid per client visit. Or, if the provider works alone or in a small practice, they can either take money from insurance companies directly or be paid directly by their clients. If a provider does not accept insurance (as I do not), they can set a rate and charge it.
If a provider decides to accept insurance, the insurance company sets the rate; there are no negotiations with the provider. And the reimbursement rate for regular talk therapy is far, far higher than it is for mental health assessment, write up, and feedback. In addition, working with many insurance companies means contacting the insurance company to get pre-approvals, filling out physical and online authorization and determination of need forms, talking to representatives of insurance companies to verify a service is covered, arguing why a client should be allowed to get tested, etc. All that time is unpaid. It is reasonable for a provider who accepts insurance for testing services to make about 20-40% per hour of testing-related activities, including working with the insurance companies, as they would if they were just offered talk therapy. Different insurance companies have different policies and processes; some reimburse more than others, and some are easier to work with than others. But I don’t think you will ever hear a psychologist (or any other health care professional) say working with insurance companies is fun or easy.
I know some providers who have private practices who say they don’t mind working with insurance companies.
They are the outliers.
So what can you do about it?
First, call around. Use Google or specific mental health provider search services, such as Psychology Today, to find providers who offer testing near you. Find out what the wait is, if they accept your insurance, if they are private pay only, and how much testing costs.
Second, expect it will take a while to get in, and if you think you may be interested in getting tested, schedule something. I won’t speak for other providers, but I am fine with someone calling and getting something on my schedule even if they decide not to use the spot later. (I’m ok with this because if someone cancels, many other clients on the schedule would love to get in sooner and take the new open spot.) It’s much easier to schedule something sooner and cancel later than decide a month or two from now that you want testing for sure and then try to get in a month or two from now.
Talk to your provider or the organization about this before you do it, though. Some providers or companies may have policies about canceling, and you should be informed about those policies.
Third, reach out online. I am part of several mental health care Facebook groups based here in the Twin Cities. Individuals often become members and inquire about getting in for testing or other mental health services, and providers can respond to them directly. Search the social media sites you belong to and see if there are groups in your area that you can join.
Conclusion
I wish I had better news. Getting in for mental health assessment can take a while. But there are providers out there, and eventually, you will be able to get in.
David
David Nathan, MBA, PsyD, LP
I offer ADHD testing in St. Paul, MN. I would love to help you or a loved one if you are seeking an ADHD or ASD evaluation. For more information, please call me at (651) 337-3944 or fill out my contact form.
Disclaimer:
This site is for information only. It is not therapy. This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise provide any clinical opinions. If you think you need immediate assistance, call your local emergency number or the mental health crisis hotline listed in your local phone book. Use of this blog establishes your consent to the provisions of this disclaimer.
